pacemaker therapy

Question 1

what are the indications for a pacemaker? in bradycardic patients

Answer 1

patient has a slower than normal impulse formation of a symptomatic AV or ventricular conduction disturbance

Question 2

what are the indications for a pacemaker? in tachycardic patients

Answer 2

patients have a tachydysrhythmic heart rate that cannot be controlled by medications
they need a biventricular pacemaker that is used to resynchronize the heart

Question 3

what are the indications for a pacemaker for someone who is in advanced heart failure?

Answer 3

they have a biventricular pacemaker that resynchronizes the heart, this may include the ICD in patients

Question 4

two pieces of a pacemaker

Answer 4

pulse generator (outside of heart that houses the batteries) 
Leads (electrical wires that stimulate the heart)

Question 5

temporary pace makers have a pulse generator that controls what?

Answer 5

rate
strength
sensitivity

Question 6

rate

Answer 6

beats per minutes

Question 7

strength

Answer 7

amount of electrical stimulus that is sent to the heart

Question 8

sensitivity

Answer 8

the amount of intracardiac activity that needs to be sensed by the electrodes for an impulse to sensed by the decide

Question 9

what are the indications for a temporary pacer

Answer 9

MIS (if they are on beta blockers that slow the heart), emergent situations and elective medical procedures

Question 10

how long does a permeant pacer last?

Answer 10

6 to 12 years

Question 11

what will need to be adjusted on a persons permanent pace maker?

Answer 11

Rate, sensitivity, strength

Question 12

how does the generator function?

Answer 12

pace maker spikes when it doesn’t detect a beat for a certain amount of time

Question 13

what is need to be done prior to dc of a someone with pacemaker procedure

Answer 13

cxr to confirm placement
no pnuemothorax
document position of the leads

Question 14

ECG pace maker spikes

Answer 14

look different cause the electrical impulse of the heart does not come from the same place

Question 15

cardiologists pick a pacemaker based on what criteria?

Answer 15

patients dysrhythmia
underlying cardiac function
age

Question 16

Bi ventricular pacing is indicated by?

Answer 16

conduction disturbances
widened QRS greater than 120
ej is less than 35 %
not likely to improve with medications

Question 17

complications of pacemaker implanation

Answer 17

infection at site
dislodged or fractured leads
pacers that dont sense properly
inappropriate delivery of ICD
minimizing patient activity can help prevent complication
patients can reprogram pacers over the phone

Question 18

data for pt record of pace maker

Answer 18

type of pacemaker 
type of generator 
date and time of insertion 
location of pulse generator 
stimulation thershold 
pacer settings

Question 19

most common complications of pacemaker

Answer 19

bradycardia and decreased cardiac out put

Question 20

indications of ICD

Answer 20

high risk for VT
high risk for VF
survived sudden cardiac death caused by VF
patients who are CHF and 40 days post MI with moderate or severe LV dysfunction
patients can feel the shock

Question 21

how does an ICD work?

Answer 21

monitors heart rhythm identifies and defibrillates in order to get back to sinus rhythm 
Includes 
anti-tachycardic 
cardioversion 
defib 
bradycardia pacing

Question 22

initial post op mangment of ICD placement

Answer 22

bleeding
hematoma
infection
assess activation status of device, heart rate
report throbbing pain to healthcare provider

Question 23

prior to dc of ICD placement

Answer 23

cxr pneumo and lead placement

no movement

Question 24

cardiologists pick a pacemaker based on what criteria?

Answer 24

patients dysrhythmia
underlying cardiac function
age

Question 25

Bi ventricular pacing is indicated by?

Answer 25

conduction disturbances
widened QRS greater than 120
ej is less than 35 %
not likely to improve with medications

Question 26

complications of pacemaker implanation

Answer 26

infection at site
dislodged or fractured leads
pacers that dont sense properly
inappropriate delivery of ICD
minimizing patient activity can help prevent complication
patients can reprogram pacers over the phone

Question 27

data for pt record of pace maker

Answer 27

type of pacemaker 
type of generator 
date and time of insertion 
location of pulse generator 
stimulation thershold 
pacer settings

Question 28

most common complications of pacemaker

Answer 28

bradycardia and decreased cardiac out put

Question 29

indications of ICD

Answer 29

high risk for VT
high risk for VF
survived sudden cardiac death caused by VF
patients who are CHF and 40 days post MI with moderate or severe LV dysfunction
patients can feel the shock

Question 30

how does an ICD work?

Answer 30

monitors heart rhythm identifies and defibrillates in order to get back to sinus rhythm 
Includes 
anti-tachycardic 
cardioversion 
defib 
bradycardia pacing

Question 31

initial post op mangment of ICD placement

Answer 31

bleeding
hematoma
infection
assess activation status of device, heart rate
report throbbing pain to healthcare provider

Question 32

prior to dc of ICD placement

Answer 32

cxr pneumo and lead placement

no movement

Question 33

zole life vest

Answer 33

used and monitors heart rhythm and defibs when goes into VT or VF.. given